Related Experiment Videos
Surgical service nosocomial infections at a Veterans Administration medical center
Abstract:
Nosocomial surgical infections at a Veterans Administration medical center were monitored from February 1986 to June 1987 (17 months). Three hundred twenty-four patients had 508 nosocomial infections, including 66 patients in whom cultures were not performed. The remaining 258 patients had 584 microorganisms, including gram-negative bacilli (56.8 percent), gram-positive cocci (33.6 percent), and yeasts (8.4 percent). The most common isolates were Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, group D enterococci, and Staphylococcus epidermidis. Antimicrobial susceptibilities were similar for nosocomial and all hospital isolates combined 84.5 percent of the time; all hospital isolates combined were more resistant in 5.5 percent and nosocomial isolates in 10.0 percent. The infection rate for surgical wounds was only 2.5 percent. When all nosocomial infection sites were compared, however, the rate for lower respiratory tract and some other infections appeared high and disproportionate. The significance of this finding is questionable because of a lack of comparable published reports from other Veterans Administration medical centers. The importance of patient population at risk of obtaining some nosocomial infections (especially lower respiratory) may be greater in adult men than in other patient populations.
Insights
Nosocomial infections in surgical patients were studied. While surgical wound infection rates were low, lower respiratory tract infections were disproportionately high, particularly in adult men.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Antimicrobial Resistance
Background:
- Nosocomial infections pose a significant threat in healthcare settings.
- Understanding microbial patterns and resistance is crucial for infection control.
- Surgical site infections are a common concern, but other sites may also be affected.
Purpose of the Study:
- To monitor and analyze nosocomial infections in surgical patients at a Veterans Administration medical center.
- To identify common microorganisms causing infections and assess their antimicrobial susceptibility.
- To compare infection rates across different sites and identify potential risk factors.
Main Methods:
- Prospective monitoring of nosocomial infections in surgical patients over a 17-month period (February 1986 to June 1987).
- Collection and analysis of microbiological data, including identification of causative agents and antimicrobial susceptibility testing.
- Calculation and comparison of infection rates for surgical wounds versus other infection sites.
Main Results:
- A total of 508 nosocomial infections were identified in 324 patients.
- Gram-negative bacilli (56.8%) were the most common isolates, followed by gram-positive cocci (33.6%) and yeasts (8.4%).
- Common pathogens included Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, group D enterococci, and Staphylococcus epidermidis.
- Surgical wound infection rate was low (2.5%), but lower respiratory tract infections appeared disproportionately high.
- Antimicrobial susceptibility patterns were largely similar between nosocomial and all hospital isolates.
Conclusions:
- While surgical wound infections were infrequent, the high rate of lower respiratory tract infections warrants attention.
- The specific patient population, particularly adult men, may be at higher risk for certain nosocomial infections.
- Further comparative studies are needed to confirm the significance of observed infection site disparities.